What you’ll learn:
- Ozempic® helps lower blood sugar and reduce appetite, but side effects like nausea and constipation are common at first and often improve as your body adjusts.
- Symptoms can often be managed with gradual adjustments to medication, diet, and lifestyle habits.
- Serious complications like pancreatitis or gallbladder issues are rare, but it’s important to stay informed, pay attention to your body, and maintain regular communication with your healthcare provider.
If you’re considering taking Ozempic®, you’ve probably heard about its power to help people lose weight (off-label), but you might be concerned about how you’ll feel taking it. While it can be a powerful tool for people who need it, it does come with some side effects, with most people experiencing some kind of gastrointestinal issues while taking it.
When will they start and how long will they last? Let’s go through what you can expect, how to manage them, and the steps for making the treatment work for you.
We’ll break down exactly how Ozempic® affects your body—what it does, how it’s taken, what side effects you might experience, and how to manage them. That includes the common ones like nausea, constipation, and appetite changes, as well as others you may have heard about. We’ll go through whether you’re likely to experience muscle loss, hair thinning, dry mouth, or facial volume loss—sometimes dubbed “Ozempic face.”
We’ll also cover the more serious but rare complications, such as pancreatitis or gallbladder issues, so you know what’s normal and what’s not. And because how quickly you increase your dose can affect how you feel, we’ll explain how dose titration works and why starting slow will help ease your experience.
How Ozempic® affects your body
Ozempic® is made with semaglutide, which mimics a hormone you already make naturally called GLP-1. This hormone plays a key role in regulating appetite, digestion, and blood sugar. When you take Ozempic®, it binds with the receptors that respond to this hormone in the digestive tract, pancreas, and brain, making them react as though they’ve gotten a large boost of GLP-1. Essentially, your body and brain think they’ve eaten enough when they haven’t.
Once in your system, Ozempic® works in a few key areas.
- In the stomach, it slows how quickly food moves through, helping you stay full longer.
- In the pancreas, it supports insulin production and lowers glucagon, which helps keep blood sugar in check.
- In the brain, it communicates with appetite-control centers, which can lead to fewer cravings and reduced hunger.
While you’re taking it, Ozempic® changes the way your body works in several important ways. This can lead to various side effects, from bloating and stomach pain to indigestion and constipation, especially if you eat more than your body can handle or foods that cause issues. Most people report some digestive side effects with Ozempic® that get better as your body gets used to the medication.
When will I experience side effects?
People are more likely to experience side effects when they first start the medication or when their dose is increased. The most common side effects are nausea, bloating, stomach pain, constipation, or diarrhea. They tend to get better as the body adapts.
To help make this adjustment easier, Ozempic® is started at a low dose, and then the dose is slowly increased over time. This is called a “step-up” or “dose-escalation” schedule. It gives your body time to get used to the medication gradually, which helps lower the chances of side effects.
You start at 0.25 mg once a week for at least a month. After that, the dose typically increases to 0.5 mg, 1 mg, and 2 mg, depending on how your body responds. Not everyone needs to increase their dose to see results.
The most common side effects and symptoms with Ozempic®
Most people experience mild to moderate symptoms that fade over time, but it’s still important to know what’s normal, what to watch for, and when to get help. Below is a breakdown of the most common and less frequent side effects to help you know what to expect and when to reach out to your healthcare provider.
Gastrointestinal symptoms
These are the most common side effects of Ozempic®, especially during the first few weeks as your body adjusts to the medication. Most symptoms are mild to moderate and tend to improve with time. Here’s a look at the specific side effects of the .5 and 1 mg doses of Ozempic®, and some tips on how to manage them.
| Symptom | Ozempic® (.5 mg dose) | Ozempic® (1 mg dose) | What can help |
|---|---|---|---|
| Nausea | 16% | 20% | Eating small, low-fat meals helps manage nausea. Avoiding greasy or spicy foods is also a widely used strategy that may make symptoms easier to handle. |
| Vomiting | 5% | 9% | Clear fluids and bland foods are often recommended to help soothe an upset stomach. |
| Diarrhea | 8% | 9% | Many healthcare professionals suggest focusing on hydration and choosing low-fiber foods to help your system recover during bouts of diarrhea. |
| Constipation | 5% | 3% | Doctors commonly recommend adding fiber slowly to your diet, staying well-hydrated, and incorporating regular movement to support healthy digestion and ease constipation. |
| Abdominal pain | 7% | 5% | Sticking with clear fluids and taking a break from solid foods for a few hours is a widely used approach for easing abdominal pain. |
| Dyspepsia | 3.5% | 2% | Try to avoid foods that trigger discomfort, reduce stress, and skip meals close to bedtime. If you have reflux, raising the head of your bed may also help. |
| Heartburn/GERD | 2% | 1.5% | Experts say lifestyle changes like losing weight, quitting smoking, and elevating your head during sleep can ease GERD symptoms. Avoiding large or late meals may also help. |
Other symptoms
While Ozempic® (semaglutide) primarily affects blood sugar and appetite regulation, some people may experience neurological and other symptoms as their bodies adjust to the medication. These effects are typically mild and transient but can impact daily life.
| Symptom | Ozempic® (1 mg dose) | What can help |
|---|---|---|
| Fatigue | Happened in >0.4% of trial participants | Common tips for reducing fatigue include having balanced meals and prioritizing good sleep habits. Healthcare experts also encourage light activity to boost energy. |
| Dizziness | Happened in >0.4% of trial participants | Keeping up with fluids and avoiding sudden movements are usual tips for managing dizziness. Standing up or moving slowly can help prevent feeling lightheaded. |
Injection site reactions
While the Ozempic® pen is designed to be simple to use and mostly painless, mild skin reactions at the injection site can occur. Here’s what you might notice:
- Redness or swelling – You may see a small red or raised spot where you gave the injection, especially in the hours right after. This is usually temporary and should go away within a day or two.
- Itching or irritation – Mild itching can happen, too. It might be a little annoying, but it typically doesn’t last long. Try not to scratch the area to avoid making it worse.
- Tenderness or bruising – Some people feel a bit of pain or see a small bruise after the shot, often depending on where the needle went in.
To lower your chances of reactions with Ozempic®:
- Rotate your injection sites each week between your abdomen, thigh, or upper arm. Keeping a chart can help.
- Always clean the skin with an alcohol swab and let it dry completely before injecting.
- Inject the medication after keeping it at room temperature for 15 minutes
- Inject the medication slowly and avoid rubbing the area afterward.
Most of the time, these reactions are mild and easy to manage with a few simple steps. If you experience any redness, ongoing pain, or signs of infection, contact your healthcare provider.
Are there any severe side effects of Ozempic®?
Ozempic® is generally considered safe for long-term use, but like any medication, it comes with potential risks. Here are some of the more serious, though rare, side effects to be aware of:
First, semaglutide carries an FDA-boxed warning about a possible risk of thyroid C-cell tumors found in animal studies. While it’s unclear if this applies to humans, you should avoid semaglutide if you or your family has a history of medullary thyroid carcinoma (MTC) or MEN 2. Always share this with your healthcare provider before starting treatment.
Here are some other potential rare side effects. If you experience any signs of these, get immediate medical attention:
- Pancreatitis: Ongoing stomach pain that spreads to your back, especially with nausea or vomiting, could signal pancreatitis. Stop the medication and get medical care right away.
- Gallbladder issues: Pain in the upper right abdomen, fever, nausea, or yellowing of the skin or eyes may point to gallstones or gallbladder inflammation.
- Kidney problems: Vomiting or diarrhea can lead to dehydration, which may strain your kidneys. Look out for fatigue, swelling, or less frequent urination.
- Severe allergic reactions: Though rare, symptoms like facial swelling, trouble breathing, or a full-body rash need emergency attention.
- Low blood sugar (hypoglycemia): This reaction is more likely if you’re also on insulin or sulfonylureas for type 2 diabetes. Signs of hypoglycemia include shakiness, sweating, confusion, or fainting.
Most people will not experience these side effects, but it’s important to stay aware. If something feels wrong or you think you’re having a serious reaction, get medical care immediately.
Are there any side effects of stopping Ozempic®?
There are no side effects of stopping Ozempic®, but you could regain weight as hunger levels return to what they were before. In clinical studies, people who stopped taking semaglutide medications like Ozempic® regained a significant portion of the weight they had lost.
If you’re planning on stopping Ozempic®, first talk to your doctor.
Here are some tips for coming off Ozempic®:
- Easing off slowly can help: Rather than quitting all at once, slowly lowering your dose by tapering with guidance from your provider may help ease the transition.
- Habits still matter most: Staying active, eating well, and having a support system are key. Tools like Noom can help you stay consistent even after you’ve stopped the medication.
Frequently asked questions about the side effects of Ozempic®
While Ozempic® is effective for weight loss and blood sugar control, some people notice changes that aren’t always listed in the medication guide. These side effects can be surprising, but many have simple explanations—and manageable solutions.
Will I lose muscle from taking Ozempic®?
When weight loss happens quickly from any source, some of it can come from muscle, not just fat. Research shows that up to 39% of the weight lost on GLP-1 medications may be lean muscle mass, which can lead to lower energy and strength. To help preserve muscle, include strength training exercises in your routine and aim to get enough protein in your diet.
Is a gaunt face a side effect of Ozempic®?
A gaunt face, sometimes called “Ozempic face,” can be an effect of taking semaglutide medications. Rapid weight loss affects fat all over your body, including your face. As facial fat decreases, some people notice a more hollow or aged appearance.
What to do: Aim to lose 1 to 2 pounds per week and maintain protein intake.
Is feeling cold a side effect of Ozempic®?
Weight loss and eating less can make you feel colder.
What to do: Stay active and move throughout the day.
Is hair loss a side effect of Ozempic®?
Rapid weight loss through any means can place stress on the body, which may result in temporary hair loss.
What to do: Make sure you’re eating a nutritious diet that contains enough protein, iron, and other key nutrients to support hair and overall health.
Can Ozempic® damage teeth?
Some people taking Ozempic® have reported brittle, breaking, or decaying teeth—sometimes called “Ozempic® teeth”—possibly due to dry mouth, poor nutrition, or vomiting linked to GLP-1 side effects.
What to do: Stay hydrated, maintain good oral hygiene, and speak with your doctor or dentist if you notice changes in your dental health.
Is depression a side effect of Ozempic®?
There have been some reports of people experiencing mood changes like depression or anxiety with Ozempic® and semaglutide medications. The FDA hasn’t found a link between GLP-1 medications and mood changes, but it’s continuing to evaluate the risk.
What to do: If you’re concerned about your mental health, reach out to your healthcare provider. If you’re in crisis or need immediate help, contact the Suicide & Crisis Lifeline at 988.
Does Ozempic® cause any different side effects in females?
While the list of official side effects is the same for everyone, research shows that females are more likely to report certain side effects, such as nausea, vomiting, headaches, and dizziness, compared to males.
Here are some things that females taking Ozempic® report:
- Changes in menstrual cycles: Some people have reported irregular periods or spotting while using Ozempic®. The likely cause is that rapid weight loss can influence estrogen levels, which may temporarily disrupt the menstrual cycle.
- Possible benefits for PCOS: One study found that nearly 80% of people with PCOS and a BMI over 30 who responded to semaglutide treatment experienced more regular periods after six months. These improvements may be linked to weight loss and better insulin sensitivity.
- Changes in fertility: Weight loss can lead to more consistent ovulation, potentially increasing fertility. While Ozempic® isn’t designed to treat infertility, these effects can still raise the chances of becoming pregnant. If you’re trying to conceive, you should stop Ozempic® at least two months before.
- Oral birth control may be less effective: GLP-1 medications can slow digestion, which might affect how oral contraceptives are absorbed. Talk to your provider about what type of contraceptive is right for you.
Who shouldn’t take Ozempic®
Ozempic® isn’t right for everyone. Certain health conditions and risk factors may make this medication unsafe.
You shouldn’t take Ozempic® if:
- You or a family member has a history of medullary thyroid carcinoma (MTC) or MEN 2.
- You have a known allergy to semaglutide or any of its ingredients.
Your doctor will decide if Ozempic® is right for you if you have a history of:
- Pancreatitis.
- Serious digestive issues like gastroparesis, since semaglutide slows stomach emptying and may worsen symptoms.
You should also not take Ozempic® if you are pregnant or breastfeeding.
Always talk with your healthcare provider about your medical history before starting semaglutide. They can help you decide if it’s the right option based on your needs and goals.
Read more about the safety of Ozempic®.
Comparing Ozempic® to Other GLP-1 Drugs
Ozempic® is a well-known option among GLP-1 receptor agonists, but it’s not the only one. Other medications in this class—like Wegovy®, Rybelsus®, Mounjaro®, Zepbound®, Victoza®, and Saxenda®—offer different dosing schedules, administration methods, and diabetes/weight loss outcomes. Understanding the differences can help you and your provider choose the best fit for your lifestyle and goals.
Ozempic® vs. Wegovy® (semaglutide)
Ozempic® and Wegovy® both contain semaglutide.
- Ozempic® is FDA-approved to treat type 2 diabetes but can be prescribed off-label for weight loss, with a maximum dosage of 2.0 mg per week.
- Wegovy® is FDA-approved for weight loss and the prevention of heart disease with a maximum dose of 2.4 mg per week.
Remember, whether you take Ozempic® or Wegovy®, you will be started at the lowest dose, and it will increase as needed and tolerated. Not everyone needs the highest dose to get benefits.
Here’s a look at the differences in side effects people experience at specific doses:
| Medication | Nausea | Vomiting | Diarrhea | Constipation | Abdominal pain |
|---|---|---|---|---|---|
| Ozempic® (1 mg/semaglutide)* | 20% | 9% | 9% | 3% | 5% |
| Wegovy® (2.4 mg/) | 44% | 24% | 30% | 24% | 20% |
Note: The most detailed side effect data is available for the 1.0 mg dose. In one trial, 34% of people taking 2.0 mg reported GI side effects, compared to 31% on 1.0 mg. The study didn’t break down specific symptoms like nausea, diarrhea, or constipation for the 2.0 mg group.
Ozempic® vs. Zepbound®/Mounjaro® (tirzepatide)
Tirzepatide is the active ingredient in both Zepbound® and Mounjaro®. It targets the GIP and GLP-1 hormones to regulate appetite and blood sugar.
- Since tirzepatide targets both hormones, whereas Ozempic® only targets GLP-1, tirzepatide medications may cause more weight loss.
- Both Zepbound® and Mounjaro® are weekly injections and come in the same doses. Zepbound® is FDA-approved for weight loss, while Mounjaro® is approved for type 2 diabetes but can be prescribed off-label for weight loss.
At different doses, here’s what people experienced versus Ozempic®:
| Medication | Nausea | Vomiting | Diarrhea | Constipation | Abdominal pain |
|---|---|---|---|---|---|
| Ozempic® (1 mg/semaglutide) | 20% | 9% | 9% | 3% | 5% |
| Zepbound®/Mounjaro® (15 mg/tirzepatide) | 28% | 13% | 23% | 11% | 10% |
Ozempic® vs. Saxenda®/Victoza® (liraglutide)
Saxenda® and Victoza® are brand names for medications containing liraglutide, another GLP-1 medication with similar properties.
- Saxenda® and Victoza® contain liraglutide and are injected once daily instead of once weekly like Ozempic®.
- Sazenda® is FDA-approved for weight loss and to prevent heart disease.
- Like Ozempic®, Victoza® is FDA-approved for diabetes and to prevent heart disease and can be prescribed off-label for weight loss.
Here are the percentages of people who experienced the most common side effects at the different doses of liraglutide compared to Ozempic®:
| Medication | Nausea | Vomiting | Diarrhea | Constipation | Abdominal pain |
|---|---|---|---|---|---|
| Ozempic® (1 mg/semaglutide) | 20% | 9% | 9% | 3% | 5% |
| Victoza® (1.8 mg) | 20% | 9% | 12% | 5% | N/A |
| Saxenda® (3 mg mg/liraglutide) | 39% | 15% | 21% | 19% | 5% |
Your next steps with Ozempic® and Noom
Understanding how Ozempic® works—and what to expect from it—can make a big difference in how confident and prepared you feel throughout your treatment. While it’s common to experience side effects like nausea or stomach discomfort, especially early on, most symptoms improve with time as your body adjusts.
That said, managing side effects is part of the process, and you’re not alone in figuring it out. Whether it’s learning to space out meals, refining your injection technique, or knowing when to check in with your doctor, there are ways to feel more comfortable along the way. With the right support, it’s absolutely possible to stay consistent, feel better, and see lasting progress. If you’re looking for help navigating treatment, see if you qualify for Noom Med. You’ll be paired with a clinician who can prescribe medication, if needed, and manage your prescription, including guiding you through any side effects. You’ll also have access to the full suite of Noom tools to help you design a healthy diet and exercise program while losing weight.
Note: Ozempic®, Victoza®, and Mounjaro® are not FDA-approved for treating obesity or weight loss.
